CTV National News reports on IBD, stupidity ensues

In case you missed it, I was on CTV National News earlier this week, talking about my general experience with inflammatory bowel disease, and specifically how my disease’s development fits in with results of a new study on IBD in Canada. Dr. Eric Benchimol, along with other researchers from the Institute for Clinical Evaluative Sciences (ICES, not to be confused with ISIS) and the Children’s Hospital of Eastern Ontario (CHEO) found that children who immigrate to Canada appear to take on the same risk of developing IBD that Canadian children face.

Children of immigrants from the Middle East/North Africa, South Asia, Sub-Saharan Africa, and North America/Western Europe had similar risk of IBD as children of nonimmigrants; however, the incidence remained lower among children of immigrants from other regions.

Younger age at arrival to Canada increased the risk of IBD in immigrants. Canadian-born children of immigrants from some regions assumed the high Canadian incidence of IBD, indicating that the underlying risk is activated with earlier life exposure to the Canadian environment in certain groups.

The results were interesting, but not surprising for a first generation Canadian such as myself. I’ve heard the catch-all yet indistinct explanation that IBD is caused by a combination of genetic and environmental factors many times before. From that I deduced my ancestors always had a genetic predisposition to develop IBD, but the symptoms of the disease never appeared because nothing in their environment triggered them. Being the first in my family to be born in, and grow up in, a different environment led me to develop full-blown ulcerative colitis. What exactly it is about Canada’s environment that triggers IBD remains a mystery, which is exactly why more research into IBD is needed.

Soon after CTV published the piece online, my IBD comrade Margaret alerted me to the nuggets of wisdom being shared in the comments section below the story. Rational, illuminating, and well-researched proclamations such as these:

Since such statements shouldn’t go unchallenged, I’ll say this:

To Terry Pavlenko:

Gee, why didn’t I, or anyone else with IBD, think of that? Yep, no one with IBD has ever changed their diet in an attempt to stop the suffering. If organic foods could effectively stop our immune system’s dysfunctional attacks our own bodies, everyone with IBD would be symptom-free because of course we’d eat differently.

At some point or another, and in various combination, I’ve eliminated gluten, dairy, eggs, red meat, and non-organic foods from my diet. I still had to have my colon removed. Some IBD patients have had success changing their diets. Others, like me, have not. To suggest such a simple, and purely theoretical strategy, for a disease so complex doesn’t further our understanding of IBD, which is what’s needed to truly help patients.

To Paprika1:

I’m very sorry your son developed UC, but do you really believe that 8 months of eating a few genetically modified foods were enough to trigger his disease? It seems more likely to me that the environments of both Canada and England contributed to the onset of his UC.

IBD is an autoimmune disease, and as such, there is a very real possibility that cleansing routines in the developed world – particularly the use of antibacterial soaps – are contributing to changes in our immune systems. It’s not at all ridiculous to suggest that Western hygienic practices are a contributing factor in IBD. I would assume people in England, and throughout Europe, do indeed wash their hands. And I suppose that has nothing to do with the fact that Europe has the highest prevalence of IBD in the world.

People are quick to blame Western diets for IBD, but remember that the study here linked the development of IBD with the Canadian environment, and there’s more to our environment than just what we eat.

To Elsbeth:

I’d go back to where I came from, but I already live in Toronto.

And if you think I relish being a burden on our healthcare system, I’d suggest you read this.

My thanks to Dr. Benchimol for his efforts to better understand IBD, both at the clinical and research levels. Thanks as well to Avis Favaro, CTV’s medical specialist, for covering the study’s publication and for taking the time to come to my office to speak with me. Lastly, thanks to Crohn’s and Colitis Canada for putting me in touch with ICES and Avis. I hope this study spurs more research, less presumption, and better understanding of the true pathology of Crohn’s disease and ulcerative colitis.

Dear Rasheed,
You have a better understanding of IBD than most. Many people want to explain chronic disease with a simple explanation, an incorrect application of Occam’s razor. In addition, gastrointestinal diseases are complicated by the idea that a simple diet change or removing GMO “Franken-” foods would take care of the problem. We can blame a lack of the public’s understanding of the science behind these chronic diseases, and that’s likely a failure of scientists and doctors to clearly explain our work.

I agree with you that the causes of IBD are likely complex and multifactorial. We already know that genetics contribute, but usually only a small amount. Add to that undefined environmental factors, and people get confused. Combine all of this with epi-genetics (the environment’s modification of genetic expression), the interaction between the environment and the microbiome, changes with age and gender, etc, etc… eyes become glazed. Unless the disease affects you personally, many would not be motivated to understand.

It’s unfortunate when science and medicine are politicized, as they are in the comments about GMO foods and immigrant burdening the health system. But again, people have agendas. Internet trolls have bigger agendas. I always try to avoid poking the troll. I would have considered ‘elsbeth’ a troll, but she was shut down pretty quickly by the subsequent poster.

The bottom line of this study is that the Canadian environment seems to trigger risk in some immigrant groups, with a more strong trigger when immigrants arrive earlier in their life or their children are born in Canada. This means the genes exist in those people, and early life exposure to Canada’s environment (likely multiple factors) increases their risk to a similar degree as our environment increases the risk of other Canadians. Some people (especially people from East Asia) are protected, which is intriguing if we can find protective genes.

In no place in my study do I describe that immigrants are a burden on the health system. In fact, in the article, I discussed the “healthy immigrant effect” which describes that immigrants to Canada are actually substantially healthier than Canadians, likely due to selection of the healthiest people willing to uproot their lives and come to Canada. We also know that the longer immigrants live in Canada, the more their health deteriorates and eventually ends up at a similar level to the health of non-immigrant Canadians. We are now working on a study to look at how immigrants with IBD use the healthcare system in Ontario. Sneak peek – it looks like they access the system more appropriately than non-immigrants – more outpatient visits, fewer emergency room visits, fewer hospitalizations. That study should be released in the next year, so it’s just between us! 🙂

And to the lovely ‘elsbeth’ who is on ‘fixed income’ (aren’t we all?) – if immigrants hadn’t been let in, and the children of immigrants like Rasheed hadn’t been born in Canada, the first named author on this study would not be conducting this research, because I would never have been born! 🙂

After doing a bit of research, it is clear that they are not genetic; almost not at all. The doubling rates are now faster than the human reproductive cycle. The big regional differences means that they are environmentally induced. Differences within single families means it is not something in the water or the air. That leaves food.

I think researchers are over-thinking this genetic factor; and it is distracting the attention away from the more obvious options. After all, even if there are some genetic factors, we are really not going to be able to do much about that. The real culprit is a potential toxin in our food. In other words, the auto immune diseases are really a auto poisonings. We just don’t recognize this as such because we are not accustomed to thinking of poisonings that develop over say 10-80 years. The term auto poisoning might seem strange, or dramatic. But, I think that when the environment makes a person get sick; it is called a poisoning.

Nevertheless, you are very correct in stating it is not: GMO “Franken-” foods.

Regarding: “Younger age at arrival to Canada increased the risk of IBD in immigrants.”
This is because of two reasons; firstly their exposure time is longer, and their bodies are smaller and are therefore more susceptible to this potential toxin.

Regarding: What exactly it is about Canada’s environment that triggers IBD remains a mystery.

I think it is exactly one little chemical. One that has been with us for millions of years. We’ve just started to consume a lot more of it in the last 50 years or so.

Although it most certainly does appear that these diseases are “triggered”, I don’t think that is the case. Rather it is that the body has reached a threshold for this potential toxin. Therefore, I think the auto immune diseases are really just the body’s normal response to a toxic situation. Of course, we don’t like that “normal”. We don’t think that it is “normal” because we don’t understand it yet.

Oddly, it quickly became apparent to me some of the big Different auto immune diseases may actually be one and the same.

The medical experts document the additional symptoms of the autoimmune diseases to be the external MANIFESTATIONS of the primary disease. In the case of Crohn’s /IBD, these are documented as the Extra Intestinal Manifestations. In others, the extra symptoms are documented to be Complications of the primary disease. For example, in the case of Juvenile Rheumatoid Arthritis, skin rashes and IBD are listed as complications of the Arthritis. How is that even possible? Of course, the reciprocal of this applies to Crohn’s /IBD. Joint pain is a manifestations external of the gut, of the disease.

But, to the outsider, with maybe a fresh (or distorted) perspective; it is may be completely backwards. I don’t see these as different diseases at all. Just the body location with the most severe inflammation is different. Even though they get different names; they are really two sides of the same coin.

Now, here’s the really curious question. If so many of the autoimmune diseases share so many of the common symptoms; and mimic each other; and so many people get so many of the diseases at the same time, and so many of these diseases use the same treatments, could they actually all just be the symptoms of something else. We now have something like 300,000 kids in North America with Juvenile Rheumatoid Arthritis. I’m guessing that we have about the same number with Crohn’s/IBD.

How is that possible; when only 50 years ago these diseases were both very rare? There is something else going on here. This something else being far bigger, far more sinister, and more encompassing in our environment.

What one poison could be so incredibly toxic to the human body, yet so globally widespread, and so devious in its pathology? How about a potential little toxin that is in nearly all the foods on the planet? Paradoxically, one that is nearly hidden because it is so ubiquitous. Paradoxically, one that medical science really never notices too much, because it is always present in nearly every tissue, and used by every cell in the body. Paradoxically, one that is promoted as being healthy, and good for us. And it is indeed good for us; until we reach a critical tipping point. It is an old, old friend going back to our early evolution.

The immune system works hand in hand with this old friend to keep us safe and healthy. Our higher levels of hygiene and our near sterilized foods have reduced the pathogen load our immune system would normally be dealing with. This is (in addition to our over consumption) is also causing us to we reach that critical tipping point faster and sooner. This is allowing our old friend to accumulate just a bit too much. This over accumulation causes gene expression, and an inflammatory response from the immune system.

Awesome! We need to patiently educate one person at a time… I have been on both sides, as a nurse and a patient, having Crohn’s disease is a learning curve that goes up and down like life in general. I’m learning to live with it, that does not mean I have to accept it or be identified as such… Thank you for the information.

Thank you for reading, fviolette! One of the tough parts of living with an IBD is that you always have to learn new ways to manage it – the ups and downs don’t really relent, at least they didnn’t/haven’t for me. And I’m with you on not accepting the disease. Why would anyone? We need to keeping working to live better lives with IBD; I feel like accepting the diseases isn’t helpful. But I suppose how we “accept” it is subjective.

Great post. I’ve often thought about this.
I’m the only one in my family with IBD (UC) and I’m a second generation Brit. There must be a gene in there somewhere which was triggered by something here! Gotta laugh at those comments. People still tell me what to eat so I smile and tell them I have a bag and can eat what I like without it affecting me!

My Book

Three Tablets Twice Daily is a collection of short stories about living with ulcerative colitis. You can pick up a copy from Life Rattle Press or Amazon.ca . Proceeds from book sales benefit the Crohn's and Colitis Foundation of Canada.